HomeMy WebLinkAbout2015-00516 - water softner ,. CITY OF ORONO * z 0 1 5 - 0 0 5 1 6 *
2750 KELLEY PARKWAY DATE ISSUED: 04/30/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 2545 KELLY AVE
PIN : 20-117-23-11-0023
LEGAL DESC : TOWNSITE OF LANGDON PARK
: LOT 002 BLOCK 005
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTNER
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
STATE SURCHARGE PLBG(<$500) 5.00
ECOWATER MAIL-IN FEE 2.00
3208 FIRST STREET S
WAITE PARK,MN 56387- TOTAL 22.00
(320)251-2505 Payment(s)
Minnesota State License#:plbg-PC643402 CREDIT CARD 3331 22.00
OWNER
PONZETTI, ROBERT&BARBARA
2545 KELLY AVE
EXCELSIOR, MN 55331
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permi[may be
revoked at any time for due cause.
'�1/ �� l'7'�'— �Y'��L.I'7 � �� 3O� l
Applicant Permitee Signature Date Issued By Signature Date
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IrOR GITY 11SE ONLY
�,�Q`��'`� eity of Orono
�" �Q R.p.l3ox b6 t7atc Reccivat: Pcrmit tl
�; � z�sn��:n�y ra�.«�y�
j �°�r�,_`- � CrysWl[3uy.MN 55333 App'oved Hy: Amaunt S:
��c.�3��'�.u� (932)349-460U—S19uin
�� {952)24g-4(�ib—Fax
CITY 4F ORON4—PLUMBING PERMIT
(A{I Cammerciat Permits Musi be.Ap�roved by the State Prior to City Approval)
htE r11�����w.tlli.r��n.����rK;C�F,1�)#1'[)F"t 3c� h�mE� i�f�revr� ��.�� �ci!'
GENERAL INFORMATION
t. You may appty fcsr plumhing permits by mail ar in person at thc�'ity affices. Applications will be
reviewed and a permit wiil be issued within#wo working days.
2. Permit cards will'be sent by return mail atter a rcview is compiettd. PERMiTS ARE NUT
VAL1D UNTIL YOU FtEGEIVE A PEitM[T. WORK MUST NOT�FGIN UNTIL TN�.
PERMIT CARD iS AOSTED ON TNE J08 SITE.
3. Plumbing permits may be issued ONGY to tic�nsed ptumbing contractors and to property owners
residing in the dwelEing.
4. When any new construction ar remodelin�is involved,a separate buiiciin�permit must be
��aE�ea.
S. A11 work rnvst be done in accordance wiih 5tatc Code requiremenis.
6. All work must be inspected and air tested before it is eQvered. Cali(952)24�1-460U.
(24-4$itour notice required)
TYl'E UF PERMIT
:Check Atl That A (
�Residential ❑�ammercial(Approvat Required)
❑New ❑Additiona) ❑Repairs Q ReplAte
❑ [n Accessory Structure?
*You wiil need�riar anprovai and may need�'l�P.(Per Orona City Godc,Chapter 7$,Article IV)
Job Site'/(hvner Information:
s�tQ Aa�r�ss: 2545 Kelly Avenue
Owner:��r�arS PQC1Z�tt) Mailing Address: �545 Keliy Avenue
�;�,_ Excelsiar ���. 55331
Home Phane: �9��} 471-8750 a�x�rnat�Ahone:
Cantxactor Information:
Contractor:, ECQWr'���'1" Contact P�rson: TO+C�C�
Address: ���.�irst Street South $tate Bood#: �'����4Q2
City: �aite Park ��pM 5638� Expicaiion Date: 1������3
Phone: �3�0} 251-25�5 Alternate Phone:
Q Mnsurance—Current: ���
1
�}.�y . _..
�; � �.��\4�,,,a.�'�,�'�. �•1�K� �_,":. . . '. '. � ��������"a� $ `���.,
FIXTURE BSMT' 1' 2' OTHER FIXTURE BSMT I' 2' f.�ThIER
TYPE FL �`L TYPE> F[� FG
Water Closet Floor C7raihs
Lavatory Se�ver Ejector
Bathkub Laundry Tray
Shoever Washer
Kitchen Sink Water Heater
Disposai Vi+at�r Softener .�
Dishwasher Wet Bar
Silicocks Miscellaneous
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� Yes,this sectian applies
The replacement of anly one Residential#ixtuce or appliance that m�ets atl three afthe follawing
requirements:
l. ` n t require modificatiqn to eleeirical ar�as service..
2. Has a tata!cost of�300.ft0 or}ess;cxc udin the cast of the fixture or applianre:and
3. ls impcoved,installed or replaced by the kameor+aner c�r lictnsed plumhing cantractnr.
Skip n�ct section,if this applies; Cast of Permit $ 15:00
State Surcharg� $ S'.�Q
Mail-[n Fee ttf Applicable) $ ?.Ob
Total Permit Fee $ �•�
{Permit Fers Cantinuei!On Next Page}
2
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,� �. ����',��IEt�IIT' � ° � ���� �,���t°���' Q���,��
ff abovc daes not apply;fallow guidtlines below:
t, C4NTRACT PRICE *is l.25°la of contract pricc with a(Minlmum F`ee of 5�50.00)
x.07 25$
{cariritct prir4) (miai�m S.'S(!,(Hi)
2, STATE:SURCHiIRG�
x:Q005 $
;contFttel}�ricr)
3, POSTAGE&HANDLING tOn1y an Mail-fn Applieaiians) $ 2.40
4. TOTAL PERM[T�EE(Add Lines l-3 Abave) $
■ * CON'CRAGT FRICE or 10B COST means the�ctuat or estimated dntfar amount char�ed fur the
permitted work including m�terisls,t�bor,profit,and other fixed cascs. lt is the amaunt to be charged
to the custo►�r for the work done. it'any meterlal;equip�ncnt, labor or instapations fue fumished by
the ownerR tenant or any other party,the�easonab)c market vatue of such items must bc added to the
estimar�d cost or cc�ntract price for permit fee purposes. In the evcnt that there is a dispute on the
amount of the job cost,the Gity may requcst the submission of a si�ned copy of the,,actual cant�ot.
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The undersigned hereby applies ta the City for issuance of a Plumbin�:Permit,agrees to da all
wark in strict accardance with the ordi�ances af the City and the regulatians af the State of
M�nnesota, and certifies that all statements made on this application are complete, #rue and
CQCI2Gt<
Appiicant's Signature: �.��-�'I �� [?ate: fl4/29/15
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